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Official Description

Repair recurrent femoral hernia; incarcerated or strangulated

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

A recurrent femoral hernia repair is a surgical procedure performed to address a specific type of hernia that has reoccurred in the femoral region, which is located in the groin area. A femoral hernia occurs when tissues, such as part of the intestine or fatty tissue, protrude through a weak spot in the femoral canal, which is situated just below the inguinal ligament and above the thigh. This condition can affect individuals of any age and may lead to complications if not treated. The procedure is particularly complex when the hernia is classified as incarcerated or strangulated. An incarcerated hernia is one where the contents of the hernia sac cannot be returned to their normal position, while a strangulated hernia indicates that the blood supply to the herniated tissue is compromised, posing a risk of tissue death. The surgical repair involves careful dissection and manipulation of the affected tissues to ensure that healthy structures are preserved while effectively addressing the hernia. The complexity of the repair can vary significantly based on the extent of the defect and the degree of scarring or damage from previous surgical interventions.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure for repairing a recurrent femoral hernia is indicated under specific circumstances, particularly when the hernia presents complications or has recurred after a previous repair. The following conditions warrant this surgical intervention:

  • Recurrent Femoral Hernia The primary indication for this procedure is the recurrence of a femoral hernia, which necessitates surgical repair to prevent further complications.
  • Incarcerated Hernia This condition occurs when the contents of the hernia sac cannot be pushed back into their normal position, requiring surgical intervention to alleviate the obstruction.
  • Strangulated Hernia A strangulated hernia is characterized by compromised blood flow to the herniated tissue, posing a risk of necrosis, and necessitating urgent surgical repair to restore circulation and prevent tissue death.

2. Procedure

The surgical procedure for repairing a recurrent femoral hernia involves several critical steps to ensure effective treatment and minimize complications. The following procedural steps are undertaken:

  • Incision An incision is made in the thigh, located below the inguinal ligament, directly over the femoral canal. This access point allows the surgeon to reach the hernia site effectively.
  • Dissection The subcutaneous fat is carefully split to expose the extraperitoneal fat that envelops the hernia sac. This step is crucial for visualizing the hernia and surrounding structures.
  • Freeing the Hernia Sac The mass of peritoneal fat is freed through blunt dissection, allowing the surgeon to access the hernia sac. Care is taken to preserve healthy tissue during this process.
  • Exposure of Structures The inguinal ligament, overlying fascia, and neck of the hernia are exposed. This exposure is necessary for the subsequent steps of the repair.
  • Inspection of Contents The fat mass is split, and the hernia sac is dissected up to and beyond its neck. The sac is then opened to inspect its contents, which may include bowel or omentum.
  • Severing Adhesions Any adhesions between the bowel, omentum, and the sac wall are carefully severed to free the herniated contents.
  • Returning Contents The bowel and omentum are returned to the abdominal cavity, ensuring that they are in their proper anatomical position.
  • Ligation and Transection The hernia sac is ligated at its neck and then transected. The stump of the sac is returned to the abdominal cavity to prevent future herniation.
  • Suturing The inguinal ligament is sutured to Cooper's ligament to reinforce the area and reduce the risk of recurrence.
  • Mesh Application A mesh plug may be applied to provide additional support to the repair, although this step is at the surgeon's discretion based on the specific case.

3. Post-Procedure

After the surgical repair of a recurrent femoral hernia, patients can expect specific post-procedure care and considerations. Recovery typically involves monitoring for any signs of complications, such as infection or recurrence of the hernia. Patients may be advised to limit physical activity and avoid heavy lifting for a specified period to allow for proper healing. Pain management strategies will be implemented to ensure patient comfort during the recovery phase. Follow-up appointments are essential to assess the surgical site and ensure that the healing process is progressing as expected. Any unusual symptoms, such as increased pain, swelling, or changes in bowel habits, should be reported to the healthcare provider promptly.

Short Descr REREPAIR FEM HERNIA BLOCKED
Medium Descr RPR RECRT FEM HRNA INCARCERATED
Long Descr Repair recurrent femoral hernia; incarcerated or strangulated
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1G - Major procedure - Other
MUE 1
CCS Clinical Classification 85 - Inguinal and femoral hernia repair
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
AG Primary physician
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CR Catastrophe/disaster related
GC This service has been performed in part by a resident under the direction of a teaching physician
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
Date
Action
Notes
2011-01-01 Changed Short description changed.
1994-01-01 Added First appearance in code book in 1994.
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